Psychogeriatric and End Life Care





Ageing can pose a number of difficulties that may result in mental health issues for older people. Forgetting things, not being able to do things you once enjoyed and feeling insecure can be the first signs of the onset of Dementia or Alzheimers. The loss of a partner or physical ailments may also lead to depression or anxiety.
These medical conditions require assessment to ensure the correct diagnosis can be made and the appropriate treatment plan formulated. It is important that family members and carers are also included in this process to assist with planning for the future.

Geriatrics is a branch of medical sciences, the study about aging process and disease that accompany old age. Must bemore than 2 or more different organs, and NOT complication of 1 organ disease.

Psychogeriatrics is a branch of Psychiatric medical science which study about psychology problems related to promotive, preventive, curative and rehabilitative and psychosocial problems which accompany old age.

The scope of Psychogeriatrics:
  • Psychiatry
  • Neurology
  • Geriatrics
  • Medical Rehabilitation
  • Psychology
    • Developing Psychology
    • Clinical Psychology
    • Psychoneurology
  • Social Sciences
Old age -> 60 untill 74 years old.

Aging process is definitely positive and aging process is also different among others, not simultaneously, can make disturbances, can be accelerated or delayed, and certainly aging process is a decreased the function of body physiologic.





Psychogeriatrics disorders:
  • Dementia
  • Mood disorders
    • Depression
    • Grieving
    • Anxiety
  • Psychosis of old age
  • Sexual dysfunction
  • Behavior disorders
    • Lobe frontalis syndrome
    • Paranoid syndrome
    • Changed personality
  • Sleep disorder



Dementia
Dementia is a decline of reasoning, memory, and other mental abilities (the cognitive functions). This decline eventually impairs the ability to carry out everyday activities such as driving; household chores; and even personal care such as bathing, dressing, and feeding (often called activities of daily living, or ADLs). (Emedicinehealth.com)

Causes of Dementia
D egeneration and drugs
E motion
M etabolism
E nergy
N utrition
T umor
I nfection
A rteriosclerosis

Demrntia care
Must be holistic and using Psychopharma with motto Start Slow, Go Slow" or using reminisence therapy or modified occupational therapy.

Depression
For old people, depression is very dangerous, why? because the symptoms of his/her depression can't be seen the effects are more severe depression neglecting him/her self even suicide.

Grieving

Sleep disorder
For old age care, old people should be active in daytime.

Sexual Dysfunction
  • Men
    • Impotency
  • Women
    • Vaginal mucosal is thinner
    • Painful intercourse
    • Uterus contraction (orgasm) till painful

Behavior disorder
  • Lobe frontalis syndrome
    • Atrophy or damaged in frontalis lobe in brain,it's make dysinhibition etically or morally, so the sex behavior is deviated and also antisocial
  • Post power syndrome
    • seems fussy, arrogant, easily fall down in depression
  • Sundowning syndrome
    • Mass hysteria
  • Changed behavioral


How to diagnose?
  • Observation and interview
    • In this section, doctor or psychiatry should aware about the way to interview and they should be really pay attention to the patients, they have to see the gestures of the patient, patient's words, the expression of the patient, and everything (the patient's ways to express)
    • Psychoneuro examination
Therapy
  • Musical therapy
  • Environment therapy


Slides by Profesor Dr. Marlina. dr, Sp.KJ(K)


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